Community nursing is important to caring for patients as part of a holistic approach. By using Chronic Disease Self-Management (CDSM) and Trans-Theoretical Lifestyle Model of Change (TTM) nurses can ensure that care is specific to the patient, which can increase their compliance with their new program. Having the patients as involved as possible in their own care allows them to take back some of the power that health care can take away. By self-managing their chronic condition patients can live fuller lives than if they were reliant on the health care team for all planning and implementing of care. One such example of a patient who is using the CDSM is C.G., a close family friend of Nicole LeSage. C.G. suffers from rheumatoid arthritis.
C.G. is a 58-year-old female who lives in Vancouver, British Columbia with her husband. C.G.’s daughter, a doctor, also suffers from rheumatoid arthritis, and C.G.’s husband has had leukemia for the past two years. Since the whole family has to deal with (chronic) health concerns and the rest of their family lives in the Interior B.C, Nicole’s family is close to C.G.’s as Nicole’s mother grew up with C.G. and now they have also become a support system. C.G. finds it hard to focus on any positive aspects of her health. However, she is willing to try anything to change her negative mind-set on her health in order to improve the health of her family.
As the whole family has to deal with health concerns on a daily basis, her perspective on health is grim. She has been misdiagnosed by two doctors, and has tried many medications to get her symptoms under control but nothing has worked for her. Although undergoing mistrials and missteps in her journey, she has maintained good relationships with all her health care providers. She is willing to try anything once, and has followed all doctors’ orders.
Jill and Nicole initially had a meeting to discuss C.G. and determine the best course of action. Since Nicole was very familiar with the family, it was decided that Jill would conduct the interview. Since there was no previous relationship C.G. could answer the questions directly and honestly. Jill and Nicole also emailed C.G a few questions beforehand, such as what is your opinion of your health, how has your chronic illness affected your daily routine, and how have you adjusted to the changes you have had to make in your life because of your illness. Jill and Nicole interviewed C.G. individually first when she could speak honestly and privately and then sat down with her and the rest of her family for a group interview.
Having a family interview as well as interviewing C.G. individually first gave the interviewers a good perspective on the family dynamic. Since Nicole knew the family quite well, she was familiar with the family’s dynamic, whereas Jill, meeting them for the first time, was able to view the family in an unbiased light. Jill observed that although C.G.’s daughter was very knowledgeable...